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Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery

Published online by Cambridge University Press:  18 November 2019

M D Wilkie ,
D Chudek ,
C J Webb ,
A Panarese  and
G Banhegyi
M D Wilkie*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
D Chudek
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
C J Webb
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
A Panarese
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
G Banhegyi
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
*
Author for correspondence: Mr Mark D Wilkie, Department of Otorhinolaryngology – Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals, Kent Lodge, Thomas Drive, LiverpoolL14 3LB, UK E-mail: mdwilkie@doctors.org.uk
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Abstract

Objective

This study sought to compare disease recidivism rates between canal wall up mastoidectomy and a canal wall down with obliteration technique.

Methods

Patients undergoing primary cholesteatoma surgery at our institution over a five-year period (2013–2017) using the aforementioned techniques were eligible for inclusion in the study. Rates of discharge and disease recidivism were analysed using chi-square statistics.

Results

A total of 104 ears (98 patients) were included. The mean follow-up period was 30 months (range, 12–52 months). A canal wall down with mastoid obliteration technique was performed in 55 cases and a canal wall up approach was performed in 49 cases. Disease recidivism rates were 7.3 per cent and 16.3 per cent in the canal wall down with mastoid obliteration and canal wall up groups respectively (p = 0.02), whilst discharge rates were similar (7.3 per cent and 10.2 per cent respectively).

Conclusion

Our direct comparative data suggest that canal wall down mastoidectomy with obliteration is superior to a canal wall up technique in primary cholesteatoma surgery, providing a lower recidivism rate combined with a low post-operative ear discharge rate.

Keywords

Ear, MiddleCholesteatomaOtitis MediaMastoidectomyTympanoplastyTreatment OutcomeRecurrenceRetrospective Studies
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 12 , December 2019 , pp. 1074 - 1078
Copyright
Copyright © JLO (1984) Limited, 2019

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Footnotes

Mr Wilkie takes responsibility for the integrity of the content of the paper

Presented at the North of England Otolaryngology Society Autumn Meeting, 19 October 2018, Liverpool, UK.

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